Wong G W, Cheng P S
Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
Clin Endocrinol (Oxf). 2001 Apr;54(4):547-50. doi: 10.1046/j.1365-2265.2001.01252.x.
Childhood Graves' disease has been reported to be rare but preliminary epidemiological data on its incidence appeared to be high in Hong Kong Chinese children. The aim of this study is to determine the incidence of childhood Graves' disease in Hong Kong and to analyse whether there is an increasing trend of the incidence.
We established a registry of childhood Graves' disease at our centre to collect cases from four districts in Hong Kong. The diagnosis of Graves' disease was based on clinical features, diffused enlargement of thyroid gland, raised free thyroxine or triiodothyronine levels, suppressed TSH levels, and the presence of thyroid receptor antibodies. Confirmed cases of Graves' disease who resided in any of the four districts were used to calculate the incidence for the study period between 1989 and 1998.
One hundred and eighteen Chinese children under 15 years of age had a confirmed diagnosis of Graves' disease during the study period from January 1989 to December 1998. There were 11 boys and 107 girls giving a male to female ratio of 1 : 9.7. The overall incidence rates were 3.2/100 000/year and 6.5/100 000/year for the two periods 1989-93 and 1994-98, respectively. The incidence rates for girls have increased significantly (P < 0.001) from 3.8/100 000/year in 1989 to 14.1/100 000/year in 1998. The current incidence of childhood Graves' disease in our population is about eight times that reported in Danish children.
This study confirms the high incidence of childhood Graves' disease in Hong Kong and documents an increasing trend for girls. Further studies are required to reveal possible genetic or environmental factors responsible for such epidemiology in Hong Kong Chinese children.
据报道儿童格雷夫斯病较为罕见，但香港中国儿童中关于其发病率的初步流行病学数据似乎较高。本研究的目的是确定香港儿童格雷夫斯病的发病率，并分析发病率是否存在上升趋势。
我们在本中心建立了儿童格雷夫斯病登记处，以收集香港四个地区的病例。格雷夫斯病的诊断基于临床特征、甲状腺弥漫性肿大、游离甲状腺素或三碘甲状腺原氨酸水平升高、促甲状腺激素水平降低以及甲状腺受体抗体的存在。居住在四个地区中任何一个地区的确诊格雷夫斯病病例用于计算1989年至1998年研究期间的发病率。
在1989年1月至1998年12月的研究期间，118名15岁以下的中国儿童被确诊为格雷夫斯病。其中有11名男孩和107名女孩，男女比例为1:9.7。1989 - 1993年和1994 - 1998年这两个时期的总体发病率分别为每年3.2/10万和每年6.5/10万。女孩的发病率从1989年的每年3.8/10万显著增加（P < 0.001）到1998年的每年14.1/10万。我们人群中儿童格雷夫斯病的当前发病率约为丹麦儿童报道发病率的八倍。
本研究证实了香港儿童格雷夫斯病的高发病率，并记录了女孩发病率的上升趋势。需要进一步研究以揭示导致香港中国儿童出现这种流行病学情况的可能遗传或环境因素。
